The overall objective of this project is to create an effective multi-disciplinary intervention that improves health related quality of life, reduces post-traumatic stress, and increases functional status in survivors of acute lung injury. Current estimates suggest that over 200,000 people in the U.S. each year are afflicted with acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) and that this number will increase as the population ages. Modern intensive care has reduced hospital mortality in acute lung injury creating more survivors who suffer from depression, post-traumatic stress, weakness, and dyspnea that impair their health related quality of life. Currently, there is little evidence to guide clinicians on techniques to reduce the morbidity suffered by ALI/ARDS survivors. The specific aims of this project are (1) To refine and validate a case-management tool to improve the health related quality of life, reduce psychological symptom burden, and increase functional status in survivors of acute lung injury; (2) To evaluate the effectiveness of a case-manager based intervention implementing the tool developed in Aim 1 to improve the health related quality of life, reduce psychological symptom burden, and increase functional status in survivors of acute lung injury; and (3) To identify risk factors for reduced health related quality of life, increased psychological symptom burden, and poor functional status in survivors of acute lung injury. The experimental approach is a randomized clinical trial of an intervention consisting of a nurse practitioner and social worker supported by a pulmonologist, psychiatrist, and physiatrist who will employ the post-ALI/ARDS case-management tool to identify and treat complications of ALI/ARDS and critical illness. Treatment will consist of specific therapies provided by the intervention team as well as treatments that are provided within the existing healthcare system by targeted patient referral and follow-up that is managed by the intervention team. The healthcare needs of survivors of ALI/ARDS have not been addressed. An effective intervention developed by this project could improve the health related quality of life for thousands of ALI/ARDS survivors and their families each year.